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Whatever, in connection with my professional practice, or not in connection with it, in the life of men, which ought not to be spoken abroad, I will not divulge, as reckoning that all such should be kept secret.
During the second half of the 20th century the prevailing ethical climate shifted from medical paternalism to an affirmation of patients' autonomy, self-determination, and collaboration. Watson and Crick's announcement in 1956 that by elucidating the structure of the DNA molecule they had discovered the ‘ssecret of life'’ propelled a biological revolution which changed the face of medicine. Advances in molecular biology, pharmacology, genetics, assisted reproduction, and organ transplantation created unanticipated clinical dilemmas (Siegler, 1979) and gave rise to the discipline of biomedical ethics (Beauchamp and Childress, 1979). Moral concerns over experimentation with human subjects led to the development of guidelines for voluntary participation and informed consent in order to preserve the individual patient's safety, autonomy, and self-determination (Jonsen, 1997).
Standards for ethical conduct now help clinicians navigate through the complexities of modern medical practice. Guidelines for publication have also been devised in order to safeguard patients' privacy and confidentiality. Written words have greater permanence than our oral communications, and access to the medical literature through the Internet is no longer restricted to elite professional audiences.
In this editorial I will review recent controversies in the area of publication ethics, focusing on the reporting of clinical data in the form of cases, vignettes, composites, and verbatim excerpts of clinician-patient dialogues. I will offer the reader historical perspective and review some